Bonfanti G, Bozzetti F, Doci R, Baticci F, Marolda R, Bignami P, Gennari L
Br J Surg. 1982 Jun;69(6):305-7. doi: 10.1002/bjs.1800690603.
The clinical records of 61 patients who underwent extended surgery, including resection of parietes or other viscera, from 1965 to 1977 for cancer of the rectum and sigmoid were reviewed. Abdominoperineal resection was performed in 41 patients, anterior resection in 18 and Hartmann's resection in 2. The postoperative mortality rate was 8.2 per cent, the non-lethal morbidity rate 30.3 per cent, but 4 patients presented multiple complications. The 5-year survival rate was evaluated separately for patients with and without microscopic evidence of neoplastic involvement of the simultaneously excised structures; in the first group it was 32 per cent, in the second 75 per cent. Local or distant recurrence occurred in 66 per cent of patients with microscopic infiltration and in 24 per cent of patients without microscopic infiltration. These results compare favourably with those reported after ordinary resections of Dukes' C cancers of the rectum and sigmoid, and seem to justify the use of extended surgery when cancer of the rectum and sigmoid has invaded contiguous structures.
回顾了1965年至1977年间61例因直肠癌和乙状结肠癌接受扩大手术（包括切除腹壁或其他内脏）的患者的临床记录。41例行腹会阴联合切除术，18例行前切除术，2例行哈特曼手术。术后死亡率为8.2%，非致命性发病率为30.3%，但有4例出现多种并发症。对同时切除的结构有或无肿瘤浸润微观证据的患者分别评估5年生存率；第一组为32%，第二组为75%。有微观浸润的患者中66%发生局部或远处复发，无微观浸润的患者中24%发生局部或远处复发。这些结果与直肠癌和乙状结肠癌Dukes C期普通切除术后报告的结果相比更有利，似乎证明当直肠癌和乙状结肠癌侵犯相邻结构时使用扩大手术是合理的。
